Carfilzomib (Kyprolis®)

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About This Drug

Carfilzomib is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • Bone marrow suppression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and  raise your risk of bleeding
  • Nausea
  • Diarrhea (loose bowel movements)
  • Tiredness
  • Swelling of your legs, ankles and/or feet
  • Fever
  • Headache
  • Electrolyte changes
  • Muscle spasm
  • Trouble sleeping
  • Cough and trouble breathing
  • Upper respiratory infections

Note: Each of the side effects above was reported in 20% or greater of patients treated with carfilzomib alone or in combination with other medications. Not all possible side effects are included  above.

Warnings and Precautions

  • Congestive heart failure and/or risk of heart attack, which can be life-threatening
  • Changes in your kidney function, which can cause kidney failure and be life-threatening
  • Tumor lysis syndrome. This drug may act on the cancer cells very quickly. This may affect how your kidneys work. Tumor lysis can be life-threatening.
  • Inflammation (swelling) or scarring of the lungs or fluid build-up in your lungs, which can be life-threatening. You may have a dry cough or trouble breathing which may be severe.
  • High blood pressure in arteries of the lungs
  • High blood pressure, which can be life-threatening
  • Blood clots and events such as heart attack. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble  breathing, pain when breathing, and/or chest pain. Women should discuss choice of contraception and risk of blood clots with their medical team.
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug, which can be life-threatening. Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen after your infusion. If this happens, call 911 for emergency care.
  • Abnormal bleeding which can be life-threatening – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Severe decrease in platelets which can increase your risk of bleeding.
  • Rare blood vessels disorder called thrombotic microangiopathy which can affect some of your organs in your body such as your kidneys and can be life-threatening
  • Changes in your liver function, which can cause liver failure and be life-threatening
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion,  hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • This drug may impair your ability to drive or use machinery. Use caution and tell your nurse or doctor if you feel dizzy, very sleepy, and/or experience low blood pressure.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss. 
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other  helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea. 
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better.
  • Infusion reactions may occur after your infusion. If this happens, call 911 for emergency care.

Food and Drug Interactions

  • There are no known interactions of carfilzomib with food.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and  others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • A headache that does not go away
  • Blurry vision or other changes in eyesight
  • Confusion and/or agitation
  • Hallucinations
  • Trouble understanding or speaking
  • Numbness or lack of strength to your arms, legs, face, or body
  • Feeling dizzy or lightheaded
  • Trouble falling or staying asleep
  • Easy bleeding or bruising
  • Coughing up yellow, green, or bloody mucus
  • Wheezing or trouble breathing
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Feeling that your heart is beating fast or in a not normal way (palpitations)
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Your leg or arm is swollen, red, warm and/or painful
  • Swelling of arms, hands, legs and/or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Decreased urine, or very dark urine
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Pain that does not go away or is not relieved by prescribed medicine
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for 6 months after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for 3 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breastfeed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised October 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.